August 28, 2009

Looking at the Public Option

One of the smartest and most successful guys I've had the privilege of knowing is engaging in our attempt at a non-partisan debate about the politically charged subject of healthcare reform. Snatching the discussion from Facebook to Cobb, we started with First Things, where the philosophy of rights and goods was, I thing a very good jumping off point about getting into the essential difference between the way the public sector rations goods and the way the private sector rations goods.

It’s a mistake to think of health care as a right. It is not a right;
it is a good. Freedom of speech, by contrast, is a right, as is freedom
of religious belief. They are privileges that inure to individuals as a
consequence of the primordial right, free will. That is why we see them
as inalienable. The exercise of these rights does not depend on any
action of government, but rather on its inaction. Government may not
legitimately interfere with their exercise, but nothing mandates that
the government provide us with printing press or chapel.

Health
care is different. It is more akin to the other goods which sustain
life: food, clothing, and shelter. A well-ordered society exists to
protect its members from the unlawful taking of life, and is structured
to facilitate its members’ acquisition of these goods.

But
health care differs from these other goods: First, health care is not
absolutely essential for all people on a daily basis; second, there is
an insufficient supply in this world to meet the demand of those who
would have it. There is enough food in the world to feed everyone.
Hunger and famine are the result of its inadequate distribution, not
its absolute dearth. There are enough garments in the world to clothe
everyone, and enough roofs to protect all from the rain. Health care,
in contrast, is a far scarcer resource. Descartes once remarked that
common sense is the most equitably distributed attribute in the world,
because we never see anybody who feels he doesn’t have enough. Health
care is not like common sense. We often see people who feel they don’t
have enough, or at least can’t get enough at a price they’re willing or
able to pay.

@Kevin
- Neither quotes from various democrats nor isolated historical
examples fit my definition of a logical, data-driven argument (and your
"bureacracy" and "socialist elite" labels come dangerously close to
crossing my no name-calling or ideology line). If a mere existence
proof was sufficient evidence of the flaw in the "public option to government
takeover is inevitable" position, I would point out that the public
option in higher education has been singularly unsuccessful in putting
the private providers out of business. I'm not taking a side here ... I
am just looking for a cogent, logical argument.

@Gary
as the doctor in the article clearly describes how they make a decision
to cover a procedure, medicine or treatment, in that decision they
always factor in the loss of that customer' business, be it an
individual or business and the potential for litigation if they don't
approve something as medically "necessay". The gov't is subject to no ..such
pressure and therefore if we go down that path rationing in whatever
form will become less "rational". Whether it is simply a public option
or evolves to single payer. I know I'm not addressing your exact
question, but I hope you recognize the concern many of us have about
the public option. If the gov't plan excludes some procedure, medicine
or treatment, private insurance may choose to use that as rationale for
exclusion and thereby negate the powerful market forces the good doc
describes. Either way, the poor who may only have the public option,
will suffer. I hope this makes some sense and you will take this as a
sincere attempt.

This is the House Democrats' big health care reform bill. Broadly, it
seeks to expand health care coverage to the approximately 40 million
Americans who are currently uninsured by lowering the cost of health
care and making the system more efficient. To that end, it includes a
new government-run insurance plan (a.k.a. a public option)
to compete with the private companies, a requirement that all Americans
have health insurance, a prohibition on denying coverage because of
pre-existing conditions and, to pay for it all, a surtax
on households with an income above $350,000. A more detailed summary of
the bill by the House Committee on Education and Labor can be read here (four-page .pdf).

Comments

Looking at the Public Option

One of the smartest and most successful guys I've had the privilege of knowing is engaging in our attempt at a non-partisan debate about the politically charged subject of healthcare reform. Snatching the discussion from Facebook to Cobb, we started with First Things, where the philosophy of rights and goods was, I thing a very good jumping off point about getting into the essential difference between the way the public sector rations goods and the way the private sector rations goods.

It’s a mistake to think of health care as a right. It is not a right;
it is a good. Freedom of speech, by contrast, is a right, as is freedom
of religious belief. They are privileges that inure to individuals as a
consequence of the primordial right, free will. That is why we see them
as inalienable. The exercise of these rights does not depend on any
action of government, but rather on its inaction. Government may not
legitimately interfere with their exercise, but nothing mandates that
the government provide us with printing press or chapel.

Health
care is different. It is more akin to the other goods which sustain
life: food, clothing, and shelter. A well-ordered society exists to
protect its members from the unlawful taking of life, and is structured
to facilitate its members’ acquisition of these goods.

But
health care differs from these other goods: First, health care is not
absolutely essential for all people on a daily basis; second, there is
an insufficient supply in this world to meet the demand of those who
would have it. There is enough food in the world to feed everyone.
Hunger and famine are the result of its inadequate distribution, not
its absolute dearth. There are enough garments in the world to clothe
everyone, and enough roofs to protect all from the rain. Health care,
in contrast, is a far scarcer resource. Descartes once remarked that
common sense is the most equitably distributed attribute in the world,
because we never see anybody who feels he doesn’t have enough. Health
care is not like common sense. We often see people who feel they don’t
have enough, or at least can’t get enough at a price they’re willing or
able to pay.

@Kevin
- Neither quotes from various democrats nor isolated historical
examples fit my definition of a logical, data-driven argument (and your
"bureacracy" and "socialist elite" labels come dangerously close to
crossing my no name-calling or ideology line). If a mere existence
proof was sufficient evidence of the flaw in the "public option to government
takeover is inevitable" position, I would point out that the public
option in higher education has been singularly unsuccessful in putting
the private providers out of business. I'm not taking a side here ... I
am just looking for a cogent, logical argument.

@Gary
as the doctor in the article clearly describes how they make a decision
to cover a procedure, medicine or treatment, in that decision they
always factor in the loss of that customer' business, be it an
individual or business and the potential for litigation if they don't
approve something as medically "necessay". The gov't is subject to no ..such
pressure and therefore if we go down that path rationing in whatever
form will become less "rational". Whether it is simply a public option
or evolves to single payer. I know I'm not addressing your exact
question, but I hope you recognize the concern many of us have about
the public option. If the gov't plan excludes some procedure, medicine
or treatment, private insurance may choose to use that as rationale for
exclusion and thereby negate the powerful market forces the good doc
describes. Either way, the poor who may only have the public option,
will suffer. I hope this makes some sense and you will take this as a
sincere attempt.

This is the House Democrats' big health care reform bill. Broadly, it
seeks to expand health care coverage to the approximately 40 million
Americans who are currently uninsured by lowering the cost of health
care and making the system more efficient. To that end, it includes a
new government-run insurance plan (a.k.a. a public option)
to compete with the private companies, a requirement that all Americans
have health insurance, a prohibition on denying coverage because of
pre-existing conditions and, to pay for it all, a surtax
on households with an income above $350,000. A more detailed summary of
the bill by the House Committee on Education and Labor can be read here (four-page .pdf).